The relationship between anxiety, gaze direction and increased falls risk in walking older adults

Older adults at a high-risk of falling tend to look away from a current stepping target in order to look at obstacles ahead. This early gaze transfer impairs the accuracy of stepping. It has previously been shown that this maladaptive gaze behaviour is associated with increased anxiety. This thesis aimed to elucidate the causal relationships between anxiety, sub-optimal gaze behaviour and increased falls risk in older adults. In separate experiments we manipulated experimental conditions to: 1) increase older participants anxiety via Social Evaluative Threat 2) reduce anxiety via relaxation exercises and 3) alter the extent to which participants previewed obstacles and walking goals via a gaze training intervention. Increasing older adults’ anxiety resulted in reduced stepping performance, and a measured reduction in anxiety was accompanied by increased stepping performance. There were few effects on eye movement timing characteristics suggesting that these changes in stepping behaviour were not mediated by altered gaze strategies. Route previewing intervention resulted in significant changes to older adults’ gaze behaviour, and improved self-confidence and stepping performance. These findings highlight the possibility of using interventions aimed at reducing anxiety and/or guiding gaze behaviour to address falls-risk in older adults